Heart & Cardiology/Help confused


I was dx with a large pericardial effusion with ct of chest  symptoms were easily winded, exhaustion, sternum pain with deep breath and difficultly taking a deep breath.... Started pacing,tried leaning onto a counter, pabick set in due to inability to breathe.  Lasted 3 minutes or so.   Had 1 liter bloody fluid drained.  Released the h
Following  day.  Two days later winded feeling increased. Echo showed reaccumulated
Ion of fluid causing thr aortic chamber to collapse. Heart itself is healthy. No arythmeas normal blood pressure elevated heart rate.  Fluid tested negative for infection or cancer but positive for inflammation.  I have had chronic sinus Inflamation. Followed by immunologist and rheumatologist.  All blood work normal excerpt elevated non specific inflammation.  All doctors feel that new pericardium symptoms and sinus stuff autoimmune in nature.  Scheduled for cardio thoractic surgeon to drain again and biopsy to try to gain more info about autoimmune component

They want to start me on prednisone.  I have read several ever reviewes articles which indicate the use of prednisone is highly controversL.

What are the pros/ cons of the use of prednisone vs Nisads?   I already have an immune system gone haywire. I work with autistic, Down syndrome and preschool disabled kids .  When put on a short 5 day burst prednisone, I pick up the virus, strep etc going around. Taking prednisone when exposed to walking peitrey dishes and having an immunune system gone haywire is of concern

Hello Amy,

You may have asked me this before.

Look at       file:///%20Cardiology%2012:07/%20Cardiology%2011:07/Pericardial%20Trouble/Pericarditis-%20Epocrates.html

Colchicine and NSAIDS are the recommended first steps in treatment.

Prednisone has the troubles you have noted, and in the long run causes loss of bone and musle and accumulation of fat in the middle of your body.

Please write back if this note doesn’t answer all your questions.

David Richardson

Heart & Cardiology

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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